Follicular Isolation Technique (FIT) And Other Essential Techniques Of FUE Hair Transplant

Hair transplant surgery found a solid ground in medical science in the 1990’s with many surgical advances concerning the FUT strip procedure to overcome or at least minimise the linear scarring and other potential invasiveness.

For the purpose of minimised scarring, extracting donor follicular units individually and directly from the donor reserve was coined with valid potentials, with Follicular Unit Extraction (FUE) procedure. This way was successful in minimizing scarring, but the early attempts were met with a loss of hair grafts being transected by the very FUE instruments while extraction. But new FUE standards of instruments as well as techniques are revving up to overcome the limitations.

As other than the scarring, FUT is still the most substantial plan to yield the best quality of hair grafts.

Fundamentals of FUE— It Is Still Follicular Transplantation

Fundamentally, with the FUE donor harvesting technique 2-5 hair follicular units that occurs naturally in the scalp, are plucked out from the donor reserve at the back of the scalp and above the ears, instead of a linear excision of a skin strip.

While FUE is at large considered to be a wholly different hair transplant technique than the FUT procedure, fundamentally it just differs by means the hair follicles are harvested, whereas, the rest of the surgical plans of follicular grafting, getting it from back of the scalp and above the ears, or techniques of planting them, are all the same. So technically, FUE is just a different type of follicular grafting, than a totally different procedure.

FUE Challenges, Techniques And Instruments

A very distinct character of hair follicles is that it changes directions and angles from that as a pact one direction bundle of hair above the surface of the scalp, while beneath the scalp skin it changes in a splaying manner. So while a hair strand has one angle on top of the scalp it is at a different opposite direction underneath which the surgeon cannot see. With this angular variation, while plucking the hair follicle, it greatly risks transecting by breaking apart with the slightest movement of the punch out of a perfect straight alignment. It is simply not possible, even with the highest experienced surgeon to attain large number of hair grafts like this.

The graft transection rate with FUE technique is not obvious either. With factors like hair strength, or scalp softness, and other many minute details, the challenges appear differently with some patients it is nominal, while sometimes it results high rate of graft transection.  The 2-step Follicular Isolation Technique and 3-step FUE techniques are coined for the manual procedure to suit up to varying candidates.

Follicular Isolation Technique (FIT) or the 2-Step FUE procedure— The idea is to pluck out intact 2-5 hair follicular units with the hair follicular bulb compact in a thin sheath of fatty tissue. To get this, very fine, specially designed blunt punches and forceps are used to create a very fine incision circling each 2-5 hair follicular unit and gently pluck it out the hair with the intact hair follicular unite, individually, one at a time, looks much like eyebrow plucking. But in the process, even though it relieves any scarring potentials, extraction of intact hair grafts is a challenge.

Three Step FUE Technique— A third step is added to the 2-Step Follicular Isolation Technique wherein a third sharp punch is used to slit the epidermis around the follicular unit before the dull punch is inserted in a twisting manner to dissect the follicular unit, and finally scoop out with the forceps.

Automated and Robotic FUE

The basic requirements of a punch and forceps is advanced into a device called Rotocore, which something liken an automated punch, that uses gentle vacuum technology helping to pull out the grafts in two and three step follicular isolation.

Robotic FUE is another extravagant technological breakthrough of the FUE procedure, which brings the apt prediction in graft excision, unachievable manually by human hands. The robot mimics the same course of procedure, with computerized precision. It is highly expensive, and not many surgeons have marveled its usage.